Home | Diagnosing ADHD in adults with co-occurring psychiatric conditions

10 May 2015

Schneider BC et al. Arch Clin Neuropsychol 2015; 30: 186-191.

Caution should be exercised when interpreting self-reported ADHD symptoms from adults with co-occurring psychiatric disorders, a recent German study reports.

This study evaluated self-reported symptoms of ADHD (using the ADHD-SR* and the WURS-SF†) in a sample of adults (n=71; aged between 18 and 69 years) referred to outpatient care for neuropsychological evaluation, and examined the association of ADHD symptoms with various neuropsychological performance measures of ADHD (including psychomotor speed, selective attention/inhibition, and verbal and non-verbal reasoning).

Using the ADHD-SR, 74.6% of patients met the cut-off for inattention and hyperactivity, 81.7% met the cut-off for impulsivity, and almost half of patients (49.3%) endorsed symptoms consistent with ADHD. ADHD-SR total scores were found to correlate significantly with WURS-SF total scores (p<0.001). However, most correlations between ADHD-SR total scores and measures of neuropsychological performance were not significant, with the exception of cognitive set-shifting ability (ability to re-direct attention; p=0.02)‡ and verbal reasoning (p=0.02).§ This suggests that endorsement of ADHD symptoms was weakly associated with poorer neuropsychological function.

These findings suggest that caution should be exercised when interpreting the complaints and self-reports of adults with co-existing psychiatric disorders, who are presenting for an assessment of ADHD, since symptoms of ADHD appear to be broadly reported but not specific to the disorder. This is supported by the lack of association between self-reported symptoms of ADHD and neuropsychological measures of ADHD in this adult population. These findings emphasise the importance of using multiple sources of information when evaluating for a diagnosis of ADHD in adults with co-occurring psychiatric conditions.

*The ADHD Self-Report Scale (ADHD-SR) is a 22-item self-report scale based on diagnostic criteria from ICD-10 and DSM-IV†The Wender Utah Rating Scale-short form (WURS-SF) is a 21-item measure which assesses the severity of ADHD symptoms‡Assessed using the Trail Making Test, Part B§Assessed using the Wechsler Adult Intelligence Test-III Similarities